BNF for Children 2011-2012

BNFC 2011–2012 Appendix 1: Interactions 735Telithromycin (continued)Antimuscarinics: manufacturer of fesoterodine advisesdose reduction when telithromycin given withfesoterodine—consult fesoterodine product literature. Antipsychotics: increased risk of ventricular arrhythmiaswhen telithromycin given with .pimozide—avoid concomitant use. Antivirals: manufacturer of telithromycin advises avoidconcomitant use with .atazanavir, .fosamprenavir,.indinavir, .lopinavir, .nelfinavir, .ritonavir,.saquinavir and .tipranavir in severe renal andhepatic impairment; telithromycin possibly increasesplasma concentration of .maraviroc (consider reducingdose of maraviroc). Anxiolytics and Hypnotics: telithromycin inhibitsmetabolism of .midazolam (increased plasma concentrationwith increased sedation)Aprepitant: telithromycin possibly increases plasmaconcentration of aprepitantCardiac Glycosides: telithromycin possibly increasesplasma concentration of digoxin. Ciclosporin: telithromycin possibly increases plasmaconcentration of .ciclosporin. Colchicine: telithromycin possibly increases risk of.colchicine toxicity—suspend or reduce dose ofcolchicine (avoid concomitant use in hepatic or renalimpairment). Cytotoxics: telithromycin possibly increases plasmaconcentration of .everolimus—manufacturer ofeverolimus advises avoid concomitant use; avoidanceof telithromycin advised by manufacturer of.lapatinib, .nilotinib and .pazopanib. Diuretics: telithromycin increases plasma concentrationof .eplerenone—avoid concomitant use. Ergot Alkaloids: increased risk of ergotism whentelithromycin given with .ergotamine and methysergide—avoidconcomitant use. Ivabradine: telithromycin possibly increases plasmaconcentration of .ivabradine—avoid concomitantuse. Lipid-regulating Drugs: increased risk of myopathywhen telithromycin given with .atorvastatin or.simvastatin (avoid concomitant use); possibleincreased risk of myopathy when telithromycin givenwith pravastatin. Ranolazine: telithromycin possibly increases plasmaconcentration of .ranolazine—manufacturer ofranolazine advises avoid concomitant useSildenafil: telithromycin possibly increases plasmaconcentration of sildenafil—reduce initial dose ofsildenafil. Sirolimus: telithromycin increases plasma concentrationof .sirolimus—avoid concomitant use. Tacrolimus: telithromycin possibly increases plasmaconcentration of .tacrolimusVaccines: antibacterials inactivate oral typhoidvaccine—see p. 620Telmisartan see Angiotensin-II Receptor AntagonistsTemazepam see Anxiolytics and HypnoticsTemocillin see PenicillinsTemoporfin. Cytotoxics: increased skin photosensitivity whentemoporfin given with topical .fluorouracilTemozolomideAntiepileptics: plasma concentration of temozolomideincreased by valproate. Antipsychotics: avoid concomitant use of cytotoxicswith .clozapine (increased risk of agranulocytosis)TemsirolimusNote The main active metabolite of temsirolimus is sirolimus—seealso interactions of sirolimus and consult productliterature. Antibacterials: plasma concentration of active metaboliteof temsirolimus reduced by .rifampicin—avoidconcomitant use. Antifungals: plasma concentration of active metaboliteof temsirolimus increased by .ketoconazole—avoidconcomitant useTemsirolimus (continued). Antipsychotics: avoid concomitant use of cytotoxicswith .clozapine (increased risk of agranulocytosis)Tenofovir. Antivirals: manufacturer of tenofovir advises avoidconcomitant use with adefovir; tenofovir reducesplasma concentration of atazanavir, also plasmaconcentration of tenofovir possibly increased; manufacturersadvise avoid concomitant use of tenofovirwith .cidofovir; tenofovir increases plasma concentrationof .didanosine (increased risk of toxicity)—avoid concomitant use; plasma concentration oftenofovir increased by lopinavirTenoxicam see NSAIDsTerazosin see Alpha-blockersTerbinafine. Antibacterials: plasma concentration of terbinafinereduced by .rifampicinAntidepressants: terbinafine possibly increases plasmaconcentration of tricyclicsCiclosporin: terbinafine possibly reduces plasma concentrationof ciclosporinOestrogens: occasional reports of breakthroughbleeding when terbinafine given with oestrogens(when used for contraception)Progestogens: occasional reports of breakthroughbleeding when terbinafine given with progestogens(when used for contraception)Ulcer-healing Drugs: plasma concentration of terbinafineincreased by cimetidineTerbutaline see Sympathomimetics, Beta 2Testolactone. Anticoagulants: testolactone enhances anticoagulanteffect of .coumarins and .phenindioneTestosterone. Anticoagulants: testosterone enhances anticoagulanteffect of .coumarins and .phenindioneAntidiabetics: testosterone possibly enhances hypoglycaemiceffect of antidiabeticsTetrabenazine. Antidepressants: risk of CNS excitation and hypertensionwhen tetrabenazine given with .MAOIsAntipsychotics: increased risk of extrapyramidal sideeffectswhen tetrabenazine given with antipsychoticsDopaminergics: increased risk of extrapyramidal sideeffectswhen tetrabenazine given with amantadineMetoclopramide: increased risk of extrapyramidalside-effects when tetrabenazine given with metoclopramideTetracosactide see CorticosteroidsTetracycline see TetracyclinesTetracyclinesACE Inhibitors: absorption of tetracyclines reduced byquinapril tablets (quinapril tablets contain magnesiumcarbonate)Adsorbents: absorption of tetracyclines possiblyreduced by kaolinAntacids: absorption of tetracyclines reduced byantacidsAntibacterials: plasma concentration of doxycyclinereduced by rifampicin—consider increasing dose ofdoxycycline; tetracyclines possibly antagonise effectsof penicillins. Anticoagulants: tetracyclines possibly enhance anticoagulanteffect of .coumarins and .phenindioneAntidiabetics: tetracyclines possibly enhance hypoglycaemiceffect of sulfonylureasAntiepileptics: metabolism of doxycycline acceleratedby carbamazepine (reduced effect); metabolism ofdoxycycline accelerated by phenobarbital andphenytoin (reduced plasma concentration)Atovaquone: tetracycline reduces plasma concentrationof atovaquoneCalcium Salts: absorption of tetracycline reduced bycalcium saltsCytotoxics: doxycycline or tetracycline increase risk ofmethotrexate toxicityAppendix 1: Interactions